Travel to Iceland Registration Form

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Travel to Iceland Registration Form June 24 June 29, 2019 Please complete all six pages of this registration form and agreement and retain a copy for your records.

1 Travel to Iceland Registration Form June 24 June 29, 2019 Please complete all six pages of this registration form and agreement and retain a copy for your records. One form for each individual passenger is necessary. In addition to this completed and signed registration form, please provide a copy of the first page of your passport, which must be valid for at least three months after our scheduled departure to Iceland and contain at least one blank page. Name and Contact Information Legal Full Name (as listed on passport): Preferred Name (what you like to be called): Home Address: Nationality: Passport Issue Date: (street) (city, state) (zip) Phone: Passport Number: Passport Expiration Date: Birthdate: Accommodations and Pricing Information Place of Birth: (state/province, country) Double accommodations are only available for travelers who agree to share space with each other in advance. We will not assign roommates to those traveling individually. See Sales Agreement page for pricing details. My roommate will be: I d like single accommodations, and my cost for this trip will be $4,495. I d like double accommodations, and my cost for this trip will be $3, of 6

2 Air Transportation Travelers are responsible for booking and purchasing their own flights to/from Keflavik International Airport to arrive on the morning of 6/24/2019. The tour will commence from the hotel with lunch at 12:30 pm local time. Travelers wishing to arrive on 6/23/2019, prior to the start day of the tour, may reserve through us an additional night at the hotel and transfer from the airport. Additional fees will apply. Health and Emergency Contact Information Please note any medical conditions of which we should be aware: Please note any allergies to medication or food: Please note any dietary restrictions (including vegetarian or vegan): In case of emergency, please notify: (name) (relationship) Primary Telephone: Secondary Telephone: Traveler Biography We ll be sharing notable information about our travelers within the group in order to know each other better ahead of the trip. Please write a brief biography, including your occupation and one or two interests. 2 of 6

3 Travel to Iceland Sales Agreement Dates June 24 to June 29, 2019 Pricing* Double (per person): $3,985 USD Single (per person): $4,495 USD *$1,000 per person will be considered a tax-deductible donation to the Authors Guild Foundation. Included Transportation from airport on 6/24/2019 (rates include grouped transfers, additional fees may apply if you require an individual transfer) Five nights accommodation with daily breakfast at the Centerhotel Arnarhvoll, Reykjavík Transportation by private tour bus to locations in the itinerary English-speaking guide for group events Lunches and dinners (including tips) as listed in the itinerary Speaker fees Entrance fees and admission to all places listed in itinerary Comfort package at Blue Lagoon Coordination of all listed activities Taxes and fees on meals and activities Pre-trip departure information 24/7 Emergency phone service Not Included Airfare to/from Iceland Airport transfers if arrival other than 6/24/2019 or departure other than 6/29/2019 Hotel accommodation for 6/23/2019 Hotel accommodation outside of normal check-in/check-out times Airline baggage fees Porterage at airport and hotels Any expenses of a personal nature, such as telephone, mini bar, etc. Meals and drinks other than those listed in the itinerary (alcoholic beverages are most often not included) Tips for guides and drivers Travel insurance (highly recommended) Unforeseen admission to nature sites Anything not listed in the itinerary 3 of 6

4 Terms and Conditions Payment A $1,000 deposit per traveler is required to complete registration for this trip. Your registration is not considered complete until your payment has been received. Full payment is due by May 6, I will pay with a check made out to the Authors Guild Foundation and mailed to 31 East 32 nd Street, Floor 7, New York, NY Please use the information below to charge my credit card: $ (amount of this payment) Card Type: Visa Mastercard Amex Discover Name on Card: Card Number: Expiration: CVV: Phone Number (required by our credit card processor for verification): Cancellation Policy There is a non-refundable $200 administrative fee for all cancellations made after any payment has been received. Cancellations prior to March 20 will result in a refund of all monies paid, except for the $200 administrative fee. Cancellations from March 20 to May 5 will result in a refund of all monies paid, except for $1,000 (this includes the $200 administrative fee). No portion of a payment kept for a cancellation penalty will be considered a tax-deductible donation. No refunds are available after May 5. We strongly recommend purchasing medical and trip cancellation insurance from a certified third-party vendor. Unused Services and Refunds No refund or adjustment can be made for any portion of the services not used, such as voluntary nonusage of hotel accommodations, scheduled meals, or any planned activity described in your itinerary. 4 of 6

5 Responsibility and Liability Statement The Authors Guild Foundation serves only to assist in making necessary travel arrangements for its participating members, and in no way represents, or acts as agent for, transportation carriers, hotels, and other suppliers of services connected with this tour. The undersigned acknowledges and agrees that travel to foreign countries may potentially involve risks including, but not limited to, terrorism, diseases, search and/or seizure of property by customs or other governmental authorities, personal liability, risk of potential injury to the undersigned, loss or damage to property belonging to the undersigned, differing customs, and legal requirements. The undersigned acknowledges that the Authors Guild Foundation and its contractors, its and their officers, members, representatives, and employees, either in their official or individual capacities, are not liable to the undersigned for any injury, damage, loss, accident, delay, or other irregularity which may be caused by the defect of any vehicle or the negligence or default of any company or person engaged in performing any of the services involved. Additionally, the undersigned agrees that the Authors Guild Foundation and its contractors, its and their officers, members, representatives, and employees either in their official or individual capacities, are not responsible for any losses or expenses due to sickness, weather, strike, hostilities, wars, natural disasters, or other such causes. All services and accommodations are provided as is and are subject to the laws of the country in which they are provided. The Authors Guild Foundation and its contractors do not accept liability for any airline cancellation or delay incurred by the purchase of an airline ticket. Baggage and personal effects are the sole responsibility of the owner at all times. The Authors Guild Foundation reserves the right to make changes in the published itineraries whenever, in its sole judgment, conditions so warrant, or if they deem it necessary for the comfort, convenience, or safety of the tour participants. The Authors Guild Foundation also reserves the right to decline to accept any person as a participant in the tour, or to require any participant to withdraw from the tour at any time, when such an action is determined by the appropriate Authors Guild Foundation staff representative to be in the best interests of the health, safety, and general welfare of the tour group or of the individual participant. The Authors Guild Foundation and its contractors shall not be responsible for a delay or failure to perform due to causes or events not within its control, including, without limitation, an act of God or government, civil disturbances, fire or other catastrophe, electrical or computer failure, telecommunication failure, disruption of public transportation, storm, or other severe weather conditions. The undersigned has read carefully the schedule of activities for this tour. The undersigned recognizes that there is a moderate level of physical activity involved in the tour and the tour may require participants to walk relatively long distances and climb stairs and that such activities carry increased levels of risk by their very nature. The undersigned client accepts any risks thereof and the conditions set forth therein. To the extent allowed by law, client agrees to release and hold harmless the Authors Guild Foundation, its contractors, and its and their officers, members, representatives, and employees, either in their official or individual capacities from any and all liability for delays, injuries, or death, or for the loss of or damage to personal property however occurring during any portion of the program. 5 of 6

6 I accept the terms and conditions of the sales agreement described in the preceding five pages for the Authors Guild Foundation trip to Iceland. Traveler Name (please print): Date: Signature: Thank you for completing your registration form. Please sign and return it to us, along with a copy of the first page of your passport. By to: landerson@authorsguildfoundation.org By mail to: The Authors Guild Foundation, 31 East 32 nd Street, Floor 7, New York, NY of 6

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